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Decision Making Process (decision + making_process)
Selected AbstractsProject Appraisal and Capital Investment Decision Making in the Scottish Water IndustryFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 1 2000Paul Coleshill Restructuring the Scottish water industry has changed the way in which both project appraisal and capital investment decisions are performed. This article examines the project appraisal and subsequent capital investment decision in the case of a reed bed sewage treatment scheme which is compared with a more traditional scheme. Although the capital profiles of the schemes are similar there are major differences in the revenue costs. In addition, there are potential public benefits to the reed bed scheme. A comparison is made of management mechanisms in the pre-1996 water industry with that of restructured water authorities. In the pre-1996 water industry, local authorities had a broad remit which encouraged them to value these factors, in effect an implicit social account. The creation of water authorities with narrow remits and specific performance measures, constructed a framework that does not support the integration of social accounts into the decision making process. The paper demonstrates that investment appraisal is a product of the institutional framework in which the decisions are made. As that framework changes, mechanisms and measures of accountability shift in parallel. [source] The Public/Private Partnership behind the Cash and Counseling Demonstration and Evaluation: Its Origins, Challenges, and Unresolved IssuesHEALTH SERVICES RESEARCH, Issue 1p2 2007James R. Knickman Objective. To discuss why and how the Cash and Counseling Demonstration came to be designed, implemented, and evaluated through a partnership between the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Robert Wood Johnson Foundation (RWJF). Principal Findings. This public/private partnership was created by two colleagues who were motivated by the need for funding to conduct a large-scale demonstration and evaluation, the prestige that both organizations brought to the project, the ability to draw on both organizations' experience and expertise, and the potential to maximize flexibility in the design and implementation of the demonstration. The partnership, which has lasted over a decade and has supported two generations of Cash and Counseling programs, overcame several challenges including getting approval for the project through their respective bureaucracies, managing the decision making process and the ongoing program across the two organizations, dealing with leadership and staff turnover, and reaching consensus on how to apportion credit for the success of the program. Several unresolved issues remain, including how the program gets operationalized within each state, how case management is addressed within the context of a consumer-directed model like Cash and Counseling, how quality is assured in this type of program, and how the Internal Revenue Service views and treats Cash and Counseling and other consumer-directed programs. Conclusion. This public/private partnership is an illustration of how public dollars can be leveraged effectively to examine a pressing policy issue and to produce information that can be translated into better policy and practice. The ASPE/RWJF collaboration made it possible to develop, test, and expand a policy-oriented demonstration project that has become a pivotal strategy in most states' efforts to build their home and community-based service systems. [source] The Selection of Multiattribute Decision Making Methods for Scholarship Student SelectionINTERNATIONAL JOURNAL OF SELECTION AND ASSESSMENT, Issue 4 2003Chung-Hsing Yeh Selecting scholarship students from a number of competing candidates is a complex decision making process, in which multiple selection criteria have to be considered simultaneously. Multiattribute decision making (MADM) has proven to be an effective approach for ranking or selecting one or more alternatives from a finite number of alternatives with respect to multiple, usually conflicting criteria. This paper formulates the scholarship student selection process as an MADM problem, and presents suitable compensatory methods for solving the problem. A new empirical validity procedure is developed to deal with the inconsistent ranking problem caused by different MADM methods. The procedure aims at selecting a ranking outcome which has a minimum expected value loss, when true attribute weights are not known. An empirical study of a scholarship student selection problem in an Australian university is conducted to illustrate how the selection procedure works. [source] Integrating new information and communication technologies in a group decision support systemINTERNATIONAL TRANSACTIONS IN OPERATIONAL RESEARCH, Issue 6 2000N. Karacapilidis Abstract We view group decision making as a collaborative process, where decision makers can establish a common belief on the dimensions of the problem by following a series of well-defined communicative actions. Having first defined these actions, this paper reports on the exploitation of recent advances in information and communication technology, which can be used to: (i) remove the communication impediments among spatially dispersed decision makers; (ii) efficiently elicit and represent the domain of knowledge; (iii) develop efficient mechanisms to structure and consistently maintain the decision analysis; and (iv) automate the decision making process itself. Automation concerns coherence and consistency checking, detection of contradictions, truth maintenance, and information retrieval techniques. [source] Men and health help-seeking behaviour: literature reviewJOURNAL OF ADVANCED NURSING, Issue 6 2005Paul M. Galdas BSc RN CertEd Aim., This paper reviews the key research literature regarding men's health-related help seeking behaviour. Background., There is a growing body of research in the United States to suggest that men are less likely than women to seek help from health professionals for problems as diverse as depression, substance abuse, physical disabilities and stressful life events. Previous research has revealed that the principle health related issue facing men in the UK is their reluctance to seek access to health services. Method., The investigation of men's health-related help seeking behaviour has great potential for improving both men and women's lives and reducing national health costs through the development of responsive and effective interventions. A search of the literature was conducted using CINAHL, MEDLINE, EMBASE, PsychINFO and the Cochrane Library databases. Results., Studies comparing men and women are inadequate in explaining the processes involved in men's help seeking behaviour. However, the growing body of gender-specific studies highlights a trend of delayed help seeking when they become ill. A prominent theme among white middle class men implicates ,traditional masculine behaviour' as an explanation for delays in seeking help among men who experience illness. The reasons and processes behind this issue, however, have received limited attention. Conclusions., Principally, the role of masculine beliefs and the similarities and differences between men of differing background requires further attention, particularly given the health inequalities that exist between men of differing socio-economic status and ethnicity. Further research using heterogeneous samples is required in order to gain a greater understanding of the triggers and barriers associated with the decision making process of help seeking behaviour in men who experience illness. [source] Do-Not-Resuscitate Policy on Acute Geriatric Wards in Flanders, BelgiumJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2005Cindy De Gendt MSc Objectives: To describe the historical development and status of a do-not-resuscitate (DNR) policy on acute geriatric wards in Flanders, Belgium, and to compare it with the international situation. Design: Structured mail questionnaires. Setting: All 94 acute geriatric wards in hospitals in Flanders in 2002 (the year Belgium voted a law on euthanasia). Participants: Head geriatricians. Measurements: A questionnaire was mailed about the existence, development, and implementation of the DNR policy (guidelines and order forms), with a request to return copies of existing DNR guidelines and DNR order forms. Results: The response was 76.6%, with hospital characteristics not significantly different for responders and nonresponders. Development of DNR policy began in 1985, with a step-up in 1997 and 2001. In 2002, a DNR policy was available in 86.1% of geriatric wards, predominantly with institutional DNR guidelines and individual, patient-specific DNR order forms. Geriatric wards in private hospitals implemented their policy later (P=.01) and more often had order forms (P=.04) than those in public hospitals. The policy was initiated and developed predominantly from an institutional perspective by the hospital. The forms were not standardized and generally lacked room to document patient involvement in the decision making process. Conclusion: Implementation of institutional DNR guidelines and individual DNR order forms on geriatric wards in Flanders lagged behind that of other countries and was still incomplete in 2002. DNR policies varied in content and scope and were predominantly an expression of institutional defensive attitudes rather than a tool to promote patient involvement in DNR and other end-of-life decisions. [source] The relationship between indecisiveness and eye movement patterns in a decision making informational search taskJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 4 2010Andrea L. Patalano Abstract Indecisiveness is a trait-related general tendency to experience decision difficulties across a variety of situations, leading to decision delay, worry, and regret. Indecisiveness is proposed (Rassin, 2007) to be associated with an increase in desire for information acquisition and reliance on compensatory strategies,as evidenced by alternative-based information search,during decision making. However existing studies provide conflicting findings. We conducted an information board study of indecisiveness, using eye tracking methodology, to test the hypotheses that the relationship between indecisiveness and choice strategy depends on being in the early stage of the decision making process, and that it depends on being in the presence of an opportunity to delay choice. We found strong evidence for the first hypothesis in that indecisive individuals changed shift behavior from the first to the second half of the task, consistent with a move from greater to lesser compensatory processing, while the shift behavior of decisive individuals suggested lesser compensatory processing over the whole task. Indecisiveness was also related to time spent viewing attributes of the selected course, and to time spent looking away from decision information. These findings resolve past discrepancies, suggest an interesting account of how the decision process unfolds for indecisive versus decisive individuals, and contribute to a better understanding of this tendency. Copyright © 2009 John Wiley & Sons, Ltd. [source] Initial Crisis Agent-Response Impact Syndrome (ICARIS)JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 4 2006Tobin Hensgen There has been a dramatic shift in attitude among organizations regarding the probabilities of crisis occurring. Once crises were considered the domain of the contingency management team that sought the fastest means to recovery, now the entire organization is compelled to take steps intended to mitigate conditions leading to a crisis. In this paper, the authors consider the organization's ,first responders' i.e., those who become involuntarily placed in the decision making process because they are the first to become aware of the conditions which indicate impending crisis simply because they are ,on scene.' As agents of the organization, these persons will make initial decisions well before the implementation of any formal contingency plan and because their decisions will be based on incomplete assumptions, they are likely to be in error. The impact of these initial crisis-agent responses can cause irreparable damage to the organization, to the individuals within the organization, and to the surrounding environment. This tendency toward error is referred to as the initial crisis-agent response impact syndrome: ICARIS. Exercising a program that prepares all employees for the initial decisions that need to be made at the moment of crisis can mitigate problems related to this issue. [source] The Mental Capacity Act 2005: implications for dietetic practiceJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2007C. Lyons Abstract The Mental Capacity Act (MCA) 2005 will be implemented in England and Wales in 2007 and have consequences for dietitians who work with people who may lack capacity to make specific decisions. This paper will explore issues arising from the introduction of the Act and considers the implications for dietitians involved in the delivery of clinical care, using enteral feeding as an illustrative example. If patients lack capacity to make specific decisions, dietitians will be required to record if, how and why they reached a decision, how they are involved in the decision making process and need to be able to justify their actions in relation to those decisions. This paper discusses the importance of dietitians' involvement in best interests decision making and considers the implications of decision making where people have drawn up a Lasting Power of Attorney. The role of such advance decisions is discussed and consideration is given to the potential compatibility of perspectives between the patient and family that may give rise to disputes. Dietitians may be well placed within multidisciplinary team working to ensure patients and their carers are part of the decision making process through effective communication and support for patients. Dietitians in England and Wales must consider the implications of the MCA upon their clinical practice and others outside these jurisdictions may like to reflect on the relevance of such developments in their own contexts. [source] The relevance of MCDM for financial decisionsJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 4-5 2002Winfried G. Hallerbach Abstract For people working in finance, either in academia or in practice or in both, the combination of ,finance' and ,multiple criteria' is not obvious. However, we believe that many of the tools developed in the field of MCDM can contribute both to the quality of the financial economic decision making process and to the quality of the resulting decisions. In this paper we answer the question why financial decision problems should be considered as multiple criteria decision problems and should be treated accordingly. Copyright © 2003 John Wiley & Sons, Ltd. [source] Influences of social support on the oral health of older people in BritainJOURNAL OF ORAL REHABILITATION, Issue 10 2002Colman McGrath summary, A national UK study involving a random sample of 876 non-institutionalized older people (aged 65 or older) were recruited, to identify the association between social support (living alone), self-reported oral health status and oral health behaviour (use of services). Home interviews were undertaken exploring oral health behaviour (time and reason for last dental visit) and oral health status measures (self-reported number of teeth possessed and denture status). In addition, socio-demographic characteristics were collected. Bivariate analysis identified that social support was associated with time since last dental visit (P < 0·01), reason for last dental visit (P < 0·01), self-reported number of teeth possessed (P < 0·01) and denture status (P < 0·01). In regression analysis, social support emerged as an important predictor of reason for last dental visit and denture status having accounted for other factors in the model (age, gender, social class and educational attainment). Social support is associated with oral health status and oral health behaviour of older people in Britain and is likely to influence both the decision making process of when to seek dental care and what type of treatment to opt for. [source] INTEGRATING HUMANS IN ECOSYSTEM MANAGEMENT USING MULTI-CRITERIA DECISION MAKING,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 2 2003Georgios E. Pavlikakis ABSTRACT: The Ecosystem Management (EM) process belongs to the category of Multi-Criteria Decision Making (MCDM) problems. It requires appropriate decision support systems (DSS) where "all interested people" would be involved in the decision making process. Environmental values critical to EM, such as the biological diversity, health, productivity and sustainability, have to be studied, and play an important role in modeling the ecosystem functions; human values and preferences also influence decision making. Public participation in decision and policy making is one of the elements that differentiate EM from the traditional methods of management. Here, a methodology is presented on how to quantify human preferences in EM decision making. The case study of the National Park of River Nestos Delta and Lakes Vistonida and Ismarida in Greece, presented as an application of this methodology, shows that the direct involvement of the public, the quantification of its preferences and the decision maker's attitude provide a strong tool to the EM decision making process. Public preferences have been given certain weights and three MCDM methods, namely, the Expected Utility Method, Compromise Programming and the Analytic Hierarchy Process, have been used to select alternative management solutions that lead to the best configuration of the ecosystem and are also socially acceptable. [source] A MODEL OF MONOPOLISTIC COMPETITION WITH PERSONAL INCOME DISPERSIONMETROECONOMICA, Issue 3 2005Corrado Benassi ABSTRACT We introduce non-homothetic preferences in the Dixit,Stiglitz model of monopolistic competition, and enquire about the effects of a change in income dispersion on the firms' optimal decisions and market equilibrium. Income dispersion, modeled as a mean preserving spread, is shown to affect only the degree of product differentiation under the standard negligibility hypothesis on the firms' decision making process, while it generates a positive co-movement of demand and demand elasticity, when this assumption is removed and the price index effect is taken into account. [source] Maternal experiences of peanut avoidance during pregnancy/lactation: An in-depth qualitative studyPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 6 2005Joanna Turke In 1998 the Department of Health Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment issued a report to British general practitioners, which advised that pregnant mothers with a family history of atopy may wish to avoid peanuts during pregnancy/lactation. To explore the lived-in experience of mothers who avoided/did not avoid peanuts during pregnancy/lactation in the light of the information issued. A qualitative approach, using unstructured in-depth interviews to explore what it was like for mothers to have a particular experience. A purposive sample frame was designed to ensure a maximum variation of participants. Forty-two interviews were conducted: 25 participants avoided peanuts; 15 with a family history of atopy and 10 with no such history. Seventeen participants did not avoid peanuts; 10 with a family history of atopy and seven with no such history. Emergent themes included: variations in information provision, a lack of clarity in relation to information and advice about peanut avoidance, the risks entailed and the introduction of peanuts to the developing child's diet; the importance of atopy in influencing participants' decisions to avoid peanuts and the importance of individual's choice in the decision making process. There was a significant difference in family size with respect to avoidance behaviour with ,avoider' families being smaller (p = 0.007). Avoidance was more likely in single child families (71% vs. 53%) although this difference was not significant. Improvements to the experience of avoidance and/or non-avoidance were primarily focused around provision of information and advice. In particular, a need for clear, consistent factual information and advice about the real risks associated with peanut consumption during pregnancy/lactation, and to whom these risks apply. [source] Insulin initiation among adults and children with diabetes in the United KingdomPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 4 2006NDNCert, PGCE Head of Department (Integrated Health, RE Davis MPhil, Social Care) Abstract There is no doubt that insulin therapy is effective in the management of people with diabetes. Indications for the use of insulin are agreed, but wide variations exist in the practice of starting people with diabetes on insulin. Current health care practices in the United Kingdom are increasingly being based on scientific evidence. This literature review concentrates on current insulin initiation practice, examining the evidence base for the insulin regimens used, the process for determining starting doses and the decision making process involved. It concludes that there are wide variations in practice among the multidisciplinary team and that there is little published regarding the commencement of people with type 2 diabetes on insulin. It is likely that custom and habit still play a large role in current practice. Copyright © 2006 John Wiley & Sons, Ltd. [source] Profiles in Patient Safety: A "Perfect Storm" in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 8 2007CCFP(EM), Samuel G. Campbell MB Correct and rapid diagnosis is pivotal to the practice of emergency medicine, yet the chaotic and ill-structured emergency department environment is fertile ground for the commission of diagnostic error. Errors may result from specific error-producing conditions (EPCs) or, more frequently, from an interaction between such conditions. These EPCs are often expedient and serve to shorten the decision making process in a high-pressure environment. Recognizing that they will inevitably exist, it is important for clinicians to understand and manage their dangers. The authors present a case of delayed diagnosis resulting from the interaction of a number of EPCs that produced a "perfect" situation to produce a missed or delayed diagnosis. They offer practical suggestions whereby clinicians may decrease their chances of becoming victims of these influences. [source] Age of sitting unsupported and independent walking in very low birth weight preterm infants with normal motor development at 2 yearsACTA PAEDIATRICA, Issue 11 2009MA Marín Gabriel Abstract Aims:, The aims of this study is to (i) determine the age of sitting unsupported and independent walking in preterm infants with birth weight under 1500 g (very low birth weight, VLBW); (ii) estimate differences between VLBW children and a reference population and (iii) estimate the association between clinical characteristics and late age at sitting and walking. Methods:, A longitudinal study was conducted of a cohort of 876 children with VLBW. The World Health Organization (WHO) motor development study population was used as a reference. Ages for both skills were established by interview with parents. Means were compared with t -test, ANOVA and Bonferroni adjustment where appropriate. Results:, The inclusion criteria were complied with 694 patients; 50% of VLBW sat at 7 m corrected age (CA) and walked at 13 m CA. Both motor skills were acquired later (7.3 ± 1.5 and 13.6 ± 2.8 m) compared with the control group (6 ± 1.1 and 12.1 ± 1.8 m). Weight or head circumference at birth below the 10th percentile or the presence of bronchopulmonary dysplasia were associated with delayed acquisition of both skills. Conclusion:, Very low birth weight infants typically sit unsupported and walk later than term infants. Tables describing reference values for milestones acquisition for different categories of infants (gestational age, birth weight and other determinants) may contribute to inform the decision making process on access to available resources. [source] Cost-effectiveness analysis based on the number-needed-to-treat: common sense or non-sense?HEALTH ECONOMICS, Issue 1 2004Ivar Sønbø Kristiansen Abstract This paper explores and critically discusses some of the methodological limitations of using the number-needed-to-treat (NNT) in economic evaluation. We argue that NNT may be a straightforward measure of benefit when the effect of an intervention is immediate, but that serious problems arise when the effect is delay rather than avoidance of an adverse event. In this case, NNT is not a robust or accurate measure of effect, but will vary considerably and inconsistently over time. This weakness will naturally spill over onto any CEA based on NNT. A literature review demonstrated that CEAs based on NNT were all published within the last five years, and that all studies suffered from important limitations. A major weakness of using NNT is the imposed restrictions on the outcome measure, which can only be strictly uni-dimensional and non-generic. Using NNT in economic evaluations is obtained at a cost in terms of both methodological shortcomings, and a reduced ability for such evaluations to serve as a useful tool in decision making processes. The use of NNT in economic evaluations might be better avoided. To every complicated question, there is a simple, straightforward, easy , and probably wrong answer (Occam's Sledgehammer). Copyright © 2003 John Wiley & Sons, Ltd. [source] Core Values, the Magistracy, and the Auld ReportJOURNAL OF LAW AND SOCIETY, Issue 2 2002Andrew Sanders In this article I shall first examine the core values underlying criminal justice about which there is some consensus. I then briefly review the current arrangements and decision making processes in magistrates courts in England and Wales before relating the core values to those arrangements and processes. This leads me to certain conclusions about the magistracy that I contrast with Auld's conclusions and recommendations. [source] Comparison study of multi-attribute decision analytic software,JOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 2-3 2005Simon French Abstract In this paper, we discuss the functionality and interfaces of five MCDM software packages. We recognize that no single package is appropriate for all decision contexts and processes. Thus our emphasis is not so much to compare the functionality of the packages per se, but to consider their fit with different decision making processes. In doing so, we hope to provide potential users with guidance on selecting a package that is more compatible with their needs. Moreover, we reflect on the further functionality which we would believe should be developed and included in MCDM packages. Copyright © 2006 John Wiley & Sons, Ltd. [source] | |||||||||||||